Alder Hey pushes the boundaries of hospital design

The new children's health park at Alder Hey pushes the boundaries of hospital design.

On paper, Alder Hey's new children's hospital and park development should never have happened. A plan to demolish an old Victorian building and build anew on a publicly owned urban greenfield site was conjured up by a disparate bunch: the local NHS trust, the now defunct Commission for Architecture and the Built Environment and The Prince of Wales's Princes Foundation – and funded through the much-criticised PFI process.

"The hospital was getting old, and we realised we couldn't keep it going," says David Houghton, estates manager for Alder Hey Children's NHS Foundation Trust. The hospital currently has Nightingale wards with 18 beds to a ward, a corridor which is three quarters of a mile (1.2km) long, a leaky roof and views on to brick walls.

Along with Dr Jane Ratcliffe, consultant in paediatric intensive care, Houghton argued not just for a new development, but a new vision for Alder Hey. "We had a park next door and wondered about using this space – initially the city [council] said 'go away, you're not using our park', as you would expect. But what grew from that was this idea of creating a children's health park."

The old hospital will be demolished and reclaimed as parkland, ultimately resulting in more park space. The park is under-used, with pitted tennis courts circled by dog-walkers. The trust's vision is for a landscaped children's sports park, wildflower meadows and improved access.

The atrium will have visually interesting things for children, including beams like dinosaur ribs.

Resistance fell away when the key stakeholders – through workshops run by the Prince's Foundation – understood that both the park and hospital would be regenerated for all. "If you call it 'the children's hospital' you are just focused on the object'", explains Ben Bolgar, senior design director at The Prince's Foundation. "But call it the 'children's health park' and you are focused on the public realm and on the space."

Not just a building located in a park

Professor James Chapman, architectural advisor on the project, explains that, "by connecting [the hospital] with the park, children in the hospital can either see the activity or be part of it ... it provides the park for the children but it also it ties the park back into the community."

The eventual design, emerging only last year after a very lengthy PFI process, came from a consortium comprising John Laing, Laing O'Rourke and Interserve, with architects BDP. "We quite quickly recognised that not only did the design have to provide the best environment for the patients and their families, but it also needed to be identifiable and iconic", explains Peter Ward, John Laing's director of healthcare projects.

"We wanted a hospital that felt so different to visiting a 'normal hospital', to look like a really exciting building as well as integrating with a park in a way that no other hospital has ever done ... The first decision was to put all the 'hot' stuff – accident and emergency, surgery departments and so on, on the lower floors, leading into an atrium that forms the heart of the hospital, which is a big open space, full of visually interesting things for children like a tree-house and beams like the ribs of a dinosaur."

It's rare to see a design that has so fully embraced the principles of wellbeing and the importance of outdoor space. The majority of patients (75%) will be in single rooms rather than wards, each with a window that can be opened out into the park. Each floor also has an outdoor balcony overlooking the park. "It's one thing to look at something out the window, it's another to actually be able to experience it yourself," says David Powell, the trust's project director.

The grass of the park also continues, seamless, up over the curving roofs of the building itself; three main sections of the building reaching out like fingers into the park, creating valleys. The green roof is not just to enhance its green credentials – Alder Hey will be the most sustainable 24-hour hospital ever built with 60% of its energy generated onsite, water-capture and ground-source heating.

"The idea was to give the sense ... of an integrated whole rather than just a building located in a park", explains Powell. From the visitors' point of view, says Houghton, "when you come in from the car park into the main atrium you can immediately see where all the connections are internally in the hospital, but also the door opposite you is a glass one going straight out into the park. From every aspect as you walk around the hospital ... there's always this connection with the green space that says 'you're part of it, go out and experience it or view it'."

Recognition of the benefits of outdoor space and views to patient recovery and general wellbeing hasn't always been, says Houghton. "I've been on this more than 10 years, and when this really took off four to five years ago, we were looking around for help and guidance and similar projects but they were just on the drawing board then too ... people thought this was only achievable in small sites, like Maggie's Centres. Achieving it on a large scale, through a PFI process, hopefully says to others in the NHS – look, other people can do this, it is possible, you can push the boundaries further."

Chapman agrees that when Alder Hey emerges, grass-roofed and full of natural light "it will change the view of what is practical. Obviously it's got to be designed economically and it's got to function. We're not ignoring those things ... this addition of green space doesn't actually add very much to the capital costs of the building ... [but] you raise the quality of the environment, and you raise the quality of life for all the people that use it."

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